Mrs Brydee Anna Cashmore1,2, Miss BINXIN HUANG1, ELLE OH1, DAVID TUNNICLIFFE1,2
1The University Of Sydney, Sydney, Australia, 2The Children’s Hospital at Westmead, Westmead, Sydney, Australia
Biography:
Brydee Cashmore is a PhD candidate at the University of Sydney and a researcher with CARI Guidelines. She specialises in chronic kidney disease, evidence synthesis, and clinical guideline development, with a focus on improving the evidence-practice gap in Nephrology.
Aim:
This study evaluated the time-lag for incorporating chronic kidney disease (CKD) randomised controlled trials (RCTs) and Cochrane reviews into nephrology clinical practice guidelines.
Background:
Despite the global burden of CKD, a persistent evidence-practice gap contributes to a concerning 17-year delay in translating research into practice. Recognising the under-representation of CKD trials in guidelines, quantifying citation timelines is essential to identify barriers and improve evidence uptake.
Methods:
We included Cochrane reviews identified from the Cochrane Database of Systematic Reviews and primary RCTs from the Cochrane Kidney and Transplant Register (published 2015–2019). Forward citation tracking (Citationchaser) determined when RCTs were cited in guidelines. Two independent authors screened and extracted data (RCTs ID, publication/citation year, time-to-citation). Cox proportional hazards models assessed the time to first citation. Sensitivity analyses explored the impact of CKD stage, and journal impact (Scopus, CiteScore) on time to citation.
Results:
Out of the 5577 records, 1085 relevant primary RCTs were identified. 19% of trails were cited in nephrology guidelines, with 87% of trials not being cited in guidelines within 5 years. The median time to citation was 46 months (IQR: 37). Higher-impact journal publication was associated with less time to citation (HR 1.08; 95% CI: 1.05-1.11) and there was no statistically significant difference in time to citation between stages. For Cochrane reviews (n=308), 58% cited in guidelines with a median time was 30 months (IQR 22-43) with kidney transplant reviews having faster incorporation than pre-dialysis reviews.
Conclusions:
A significant evidence-practice gap exists in nephrology for both RCTs and systematic reviews. Strategies to accelerate guideline evidence translation, including incorporating systematic reviews, adopting living guideline models, and targeting high-impact journal publications may improve evidence-to-practice time-lag.
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